This proposed research has two objectives. The primary objective is to investigate the relationship of mother-infant joint attention interactions and infants' ability to initiate play and use language and gestures. A second objective is to investigate the factors that are associated with mothers' use of effective attention directing strategies. Seventy 12 month old premature infants subdivided into two groups according to type and severity of medical complications associated with their prematurity will be compared with a demographically comparable fullterm control (n = 35). The groups will be compared at 12 and 24 months on maternal attention directing techniques and infant responses to these techniques. Although the higher risk infants are expected to show less advanced play and communication skills, certain joint attention processes are expected to have a facilitative effect on these skills for all groups of infants. Other maternal behaviors are hypothesized to affect infant skills differently according to degree of risk. Specifically maternal tendencies to maintain rather than redirect the infants' focus of attention will be associated with more advanced levels of play and better communication skills for all infants. However, maternal tendencies to use visually salient attention directing behaviors (such as demonstrations) and verbal behaviors that structure infant responses (such as directives) are hypothesized to be associated more often with manipulative play for high risk preterms than for lower risk preterms or fullterms. In addressing the second objective, mothers' understanding of their infants' developmental needs (such as attitudes of warmth and encouragement of independence regarding child rearing) are expected to relate to infant exploratory and communicative competence and to maternal use of effective attention directing strategies. Infants are observed in videotaped joint attention interactions with their mothers and the investigator. In addition, measures of the infants' independent play and communication skills are taken. All of the mother-infant pairs are included in the proposed study will have received similar measures at 6 months. Comparisons of the preterm and fullterm groups over time will provide information regarding the development of joint attention skills across infancy for preterm infants of varying degrees of risk. In addition, questions regarding the degree to which maternal behaviors in interactions are related to characteristics of the infant versus persistent styles of interacting can be addressed.